Respiratory Tract Infections Flashcards
How many droplets does a sneeze produce?
40,000
How many droplets does coughing produce?
3,000
What are the most effective vehicles?
Dried droplet nuclei
Why are dried droplet nuclei such effective vehicles?
They stay airborne for long period of time
1-10 micrometres in diameter
How long do droplets from Influenza (A and B) persist in the environment?
24-72 hours
How long do droplets from SAR-CoV-2 persist in the environment?
up to 3 days
How long do droplets from Bordetella pertussis persist in the environment?
3-5 days
How long do droplets from Mycobacterium tuberculosis persist in the environment?
up to 4 months
What is rhinitis?
Infection of the nose
What is sinusitis?
Inflammation of the sinuses often following a common cold infection
What is pharyngitis?
Infection of the throat
What is laryngitis?
Infection of voice box
What is tracheitis?
Infection of trachea
What is bronchitis?
Infection of bronchi
What is bronchioloitis?
Infection of bronchioles
What is pnemonia?
Infection of alveoli
What is the first line of defence of the respiratory tract?
Mechanisms to remove large incoming particles
What are 4 examples of mechanisms that remove large incoming particles?
Nasal hairs trap particles
Saliva flushing oropharynx
Mucus production throughout respiratory tract
Mucociliary system in trachea and bronchi
What happens to the first line of defence if the epithelial cells are damaged?
It won’t work, secondary bacterial infections can occur
What can damage epithelial cells of the respiratory tract?
bacteria and viruses (e.g. B. pertussis, influenza)
cigarette smoke
pollution
What is the immune response in the alveoli?
Small particles (0.05-3 micrometres) are phagocytosed by alveolar macrophages
What do mucosal secretions produce to provide immune protection?
Antimicrobial substances
- lysozyme (lyses bacteria)
- lactoferrin (iron binding protein that deprives bacteria of the free iron needed for growth)
- secretory IgA (targets specific organisms)
How are specimens collected from the respiratory tract?
Sputum is collected by coughing directly into collection tube or extracted by catheter with suction or during bronchoscopy
Throat or nasopharyngeal swabs
Blood for serological samples
What must be avoided when collecting respiratory samples and why?
Salvia because it is a contaminant due to containing millions of bacteria.
How are respiratory tract infections diagnosed phenotypically?
Through morphology, physiology of organism
- gram stain
- isolation on selective and/or differential media
- biochemical testing: enzyme production, motility, spore formation
- antimicrobial sensitivity
How are respiratory tract infections diagnosed immunologically?
Serology: characterising antibodies
- IgM detectable 4-7 days
- IgG detectable 2-4 weeks
Commercial antibody-based kits to detect pathogens
How are respiratory tract infections diagnosed genotypically?
PCR presence or absence
qPCR amount of pathogen-specific RNA or DNA
High throughput diagnostic chips
Which pathogens adhere to mucosa despite the mucociliary system? (Primary)
Influenza
Rhinovirus
Strep. pneumoniae
M. pneumoniae
Which pathogens interfere with the function of cilia? (Primary)
Bordetella pertussis
M. pneumoniae
Strep. pneumoniae
Which pathogens resist destruction in alveolar macrophages? (Primary)
Legionella
M. tuberculosis
Which pathogens cause local tissue damage? (Primary)
Corynebacterium diphtheriae
Strep. pneumoniae
What are secondary respiratory pathogens?
They are pathogens that infect the host when the host immune barriers are imparied
Which pathogens infect when there is first an initial infection by a respiratory virus?
Staph. aureus
Strep. pneumoniae
Which pathogens infect when there is physiological impairment?
Staph. aureus
Pseudomonas spp.
What disease can cause physiological impairment of the respiratory tract?
Cystic fibrosis
Which pathogens can infect when the host has chronic bronchitis?
Strep. pneumoniae
H. influenzae
Which pathogens can infect when the host is immunocompromised?
A. fumigatus
C. neoformans
What is the most deadly lower respiratory tract infection?
Pneumonia
What is the most common infection-related cause of death in developing countries?
Pneumonia
How many pneumonia deaths per year in children below 5?
935,000
What are the causative agents of pneumonia?
Bacteria
Viruses
Fungi
How do pathogens reach the lower respiratory tract?
Through deep inhalation of aerosols or aspiration of upper respiratory tract flora
What is the main failed defence that leads to pneumonia?
Inhibition of ciliary movement due to tobacco, pollution or prior infection
What are the symptoms of pneumonia?
Runny nose, congestion, headache, fever
Chest pain, cough, production of discoloured sputum, exudate, difficulty breathing
What is lobar pneumonia?
Pneumonia in a distinct region or lobe
What is bronchopneumonia?
Diffuse infection of the lung
What is interstitial pneumonia?
Invasion of the interstitium
What is a lung abcess?
Necrotising pneumonia, destruction of the lung parenchyma
What are the main causes of community acquired pneumonia?
Viral
Strep. pneumoniae
H. influenzae
What are the main causes of nosocomial pneumonia?
Klebsiella pneumoniae
Staph. aureus (MRSA)
Pseudomonas aeruginosa
P. jirovecii
What is atypical pneumonia?
Caused from environmental exposure
What are 3 examples of atypical pneumonia?
Legionella pneumophilia from cooling towers, environment
Brucella spp. Coxiella burnetti from infected animals
Aspergillus fumigatus, Crytococcus spp. from mulch and animal droppings
What percentage of hospitalised patients develop pneumonia?
1%
What is nosocomial pneumonia associated with?
Mechanical ventilation
What is the mortality rate of nosocomial pneumonia?
30-50%
What is the origin of nosocomial pneumonia?
Polymicrobial origin
How is nosocomial pneumonia diagnosed?
Microscopic examination and culture of sputum
X-ray
Bronchoscopy, bronchoalveolar lavage, biopsy
Which part of the respiratory tract does the common cold infect?
The upper respiratory tract